Walking the leadership walk: Integrating inclusivity in a large-scale health care organization.

This article focuses on the roles, actions, and resources developed by a group of leaders from the Office of Mental Health and Suicide Prevention (OMHSP) within the Department of Veterans Affairs during the unprecedented times of spring of 2020, when society was shaken by the fears and challenges of COVID-19 as well as social unrest sparked by the murder of George Floyd. We share a summary of our efforts to move beyond platitudes and statements and bring meaningful and sustainable change in justice, equity, diversity, and inclusion within OMHSP and across mental health services in Department of Veterans Affairs. This article is written through the lens of the founding members of the OMHSP's Diversity, Equity, and Inclusion Steering Committee. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

eHealth Use on Acute Inpatient Mental Health Units: Implementation Processes, Common Practices, and Barriers to Use.

Information technology to promote health (eHealth) is an important and growing area of mental healthcare, yet little is known about the use of patient-facing eHealth in psychiatric inpatient settings. This quality improvement project examined the current practices, barriers, implementation processes, and contextual factors affecting eHealth use across multiple Veteran Health Administration (VHA) acute mental health inpatient units. Staff from units serving both voluntary and involuntary patients (n = 49 from 37 unique sites) completed surveys regarding current, desired, and barriers to use of Veteran-facing eHealth technologies. Two subsets of respondents were then interviewed (high success sites in eHealth use, n = 6; low success sites, n = 4) to better understand the context of their eHealth use. Survey responses indicated that 20% or less of Veterans were using any type of eHealth technology while inpatient. Tablets and video chat were the most desired overall and most successfully used eHealth technologies. However, many sites noted difficulty implementing these technologies (e.g., limited Wi-Fi access). Qualitative analysis of interviews revealed differences in risk/benefit analysis and implementation support between high and low success eHealth sites. Despite desired use, patient-facing eHealth technology is not regularly implemented on inpatient units due to multiple barriers (e.g., limited staffing, infrastructure needs). Successful implementation of patient-facing eHealth may require an internal champion, guidance from external supports with experience in successful eHealth use, workload balance for staff, and an overall perspective shift in the benefits to eHealth technology versus the risks.

Recovery-oriented inpatient mental health care and readmission.

OBJECTIVE: This article examines the relationship between inpatient mental health units' adherence to recovery-oriented care and 30-day patient readmission. METHOD: The sample included patients admitted to one of 34 Veterans Health Administration inpatient mental health units. Recovery-oriented care was assessed using interviews and site visits. Patient characteristics and readmission data were derived from administrative data. FINDINGS: Overall recovery orientation was not associated with readmission. Exploratory analyses found higher scores on a subsample of items pertaining to inpatient therapeutic programming were associated with lower patient readmissions. Additionally, patients with more prior service use and substance abuse or personality disorders were more likely to be readmitted. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: A growing body of literature supports the association between psychotherapeutic services in inpatient units and better patient outcomes. However, further research is needed to examine this association. More work is needed to develop appropriate psychotherapy services for the inpatient setting and support their implementation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recovery-oriented acute inpatient mental health care: Operationalization and measurement.

OBJECTIVE: The current article describes efforts to develop and test a measure of recovery-oriented inpatient care. METHOD: The Recovery-oriented Acute INpatient (RAIN) scale was based on prior literature and current Veterans Health Administration (VHA) policy and resources and further revised based on data collection from 34 VHA acute inpatient units. RESULTS: A final scale of 23, behaviorally anchored items demonstrated a four-factor structure including the following factors: inpatient treatment planning, outpatient treatment planning, group programming, and milieu. While several items require additional revision to address psychometric concerns, the scale demonstrated adequate model fit and was consistent with prior literature on recovery-oriented inpatient care. Conclusions and Implementations for Practice: The RAIN scale represents an important tool for future implementation and empirical study of recovery-oriented inpatient care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Envisioning Transformation in VA Mental Health Services Through Collaborative Site Visits.

This column reviews the unique contributions of multiple partners in establishing a standardized site visit process to promote quality improvement in mental health care at the Veterans Health Administration. Working as a team, leaders in policy and operations, staff of research centers, and regional- and facility-level mental health leaders developed a standardized protocol for evaluating mental health services at each site and using the data to help implement policy goals. The authors discuss the challenges experienced and lessons learned in this systemwide process and how this information can be part of a framework for improving mental health services on a national level.

A new multidimensional model of successful aging: perceptions of Japanese American older adults.

This study examined the concept of successful aging using an ethnographic grounded-theory approach. Seventy-seven Japanese American older adults participated in focus groups. Participants perceived successful aging as optimal functioning in the following areas: Physical health, psychological health, cognitive functioning, socialization, spirituality, and financial security. The content of each dimension represents both culture-specific and culturally-universal elements. This new multidimensional model of successful aging was compared to Rowe and Kahn's (The Gerontologist 37:433-440, 1997) and Phelan et al.'s frameworks (Journal of the American Geriatric Society 52:211-216, 2004) of successful aging. The model of successful aging generated from this study appears to be more comprehensive than existing models and incorporates sociocultural experiences.

Personal reflections: barriers and strategies in increasing diversity in psychology.

In this article, six faculty and students of color who participated in a panel discussion at a symposium during the National Multicultural Conference and Summit of 2003 talk about the barriers they encountered and continue to encounter in their graduate training and places of employment. They also discuss strategies they found to be effective, enhancing, and positive and suggest other possibilities. The contributors describe their relationships with dominant-group and minority peers and talk about how issues of social class, disability, and sexual orientation as well as color have been part of their experience.

Ethnicity and clinical psychology: a content analysis of the literature.

As the demographics of the U.S. population continues to change and become increasingly diverse, clinical psychologists will need to demonstrate their competence in providing culturally appropriate treatments to a wide variety of populations. This article summarizes a comprehensive content analysis of five of the leading scholarly journals in clinical psychology over a 17-year period (1980-1997). Results indicate that only 29.3% of the published articles in the clinical psychology literature included ethnic minority participants. Furthermore, only 5.4% of the articles actually focused specifically on ethnic minority populations. Thus, the clinical psychology literature does not contain adequate coverage of ethnically diverse populations in the U.S., despite their growing numbers. This content analysis provides the field with a baseline for future comparison to determine whether the field in general is responding to the needs of an increasingly diverse society, and to help gauge whether clinical psychologists have the scholarly resources available to assist them with becoming more culturally competent. Implications for the paucity of research and recommendations to ameliorate the problem are discussed.

Acculturation of Japanese Americans:: Use of the SL­ASIA with a Community Sample.

PURPOSE. The present article summarizes the use of the Suinn­Lew Asian Self Identity Acculturation Scale (SL­ASIA) with a community sample of Japanese Americans. METHODOLOGY. The SL­ASIA was administered to 123 Japanese Americans in Los Angeles, CA. Analyses of internal consistency and concurrent validity were conducted. PRINCIPAL FINDINGS. Results indicated that the mean SL­ASIA score for this sample was 3.25, which according to the scale developers' conceptualization of acculturation, indicates a medium level of acculturation. Analyses revealed no gender differences. Psychometric properties of the SL­ASIA with this community sample of Japanese Americans appear to be adequate. Obtained correlation coefficients were somewhat lower than those found for college students; however, they still were in a reasonable range. Concurrent validity of the SL-ASIA was demonstrated with several other variables such as generational status and self-identification. CONCLUSIONS. This article presented the results of analyses of the SL­ASIA with a community sample of Japanese Americans. Results indicated that, although the correlation coefficients obtained from analyses examining internal consistency and concurrent validity were lower for this sample as compared to those found with college student samples, the SL­ASIA was found to have adequate psychometric properties with this community sample. Thus, results indicate that the SL­ASIA would be an appropriate screening measure to assess acculturation level among Japanese Americans in the community. RELEVANCE TO ASIAN AMERICAN AND PACIFIC ISLANDER POPULATIONS. This article is particularly relevant to Japanese Americans. KEY WORDS. Acculturation, Japanese Americans, moderator variables, psychometric analyses.